A Nurse Sounds Off… Violence against healthcare workers

There is a very fundamental problem in U.S. healthcare and that is violence against healthcare workers.

If you haven’t picked up on the fact that this issue is a highly sensitive topic, then you haven’t been paying attention. Healthcare workers shouldn’t be managed as a commodity for a consumer to use and abuse. But the million-dollar question is, who is held accountable when a healthcare worker is attacked, abused verbally, physically or emotionally by patients?

This month a warrant was issued for the mental health patient accused of attacking a Baton Rouge nurse, who died days after she was physically attacked by the patient. So it can be said that baby steps are in motion though. The nurse obtained abrasions to the back of her neck and a torn ACL that required surgery for repair. The nurse visited the ER twice after the occurrence and the second visit led to her being admitted into ICU. Within hours the nurse had died after multiple attempts to revive after cardiac arrest.

The U.S. Bureau of Labor Statistics tracks incidence rates of nonfatal occupational injuries and illnesses involving days away from work, including “intentional injury by other person.” Of the 18,400 such injuries reported in the private industry in 2017, 71% were reported in the healthcare and social assistance sector. And this only includes incidents that involved days away from work.

While 61 percent of all RNs work in hospitals, 74.1 percent of all nonfatal workplace injuries and illnesses to RNs in 2016 occurred in hospitals.

So again, who is ultimately responsible for the safety and concern of the human being taking care of the patients? The answer seems clear on the surface right, the employer should be responsible for the well-being of its employees, right? I pose that as a question instead of a statement because more often than not employers are straddling an invisible line between ethical and moral obligations to its employees and providing an easily accessible facility for patients to seek treatment and care. What hospital system wants to hold a patient accountable for the mistreatment of a healthcare provider?

Some would say that hospitals are erring on the side of caution to: 1. Protect the patient and 2. Protect the reputation of their healthcare machine. Because, let’s be honest, if a hospital were to hold a patient accountable for the mistreatment of a healthcare worker it would likely gain an unfavorable reputation in the community, which in turn is bad for business. You may think this perspective is cynical but that doesn’t make it any less true.

“There is a very fundamental problem in U.S. healthcare that very few people speak about, and that’s the violence against healthcare workers,” said Dr. Tom Mihaljevic, president and CEO of Cleveland Clinic. “Daily, literally daily, we’re exposed to violent outbursts, in particular in our emergency rooms.” Very few people outside of the medical community understand the emotional and physical abuse that frontline healthcare workers endure. If the healthcare community doesn’t speak louder about this serious issue, then those outside the community will never understand. A healthcare provider signs up to heal and protect not to be punched, bitten, scratched and called horrible names. Advocating for a safer workplace, supporting our security staff and listening to the victims of abuse are just a tip of the iceberg of call to actions.

Security measures such as panic buttons, badge access units, limited guest hours and metal detectors are all steps in the right direction. Facility administration and healthcare workers need to come together and formulate a plan to mitigate the risk associated with these security risk. This collaboration could result in a comprehensive and systematic approach to address a balance of care for all involved.

No matter the reason for the lack of support for the frontline clinician, it is important to come together as a whole from the CEO at the top to the support staff on the unit. Acting as a tribe to protect each other is the ultimate goal.